50 - Gastroenterology

Abstract

Aging induces physiological changes throughout the gastrointestinal (GI) tract, with changes in motility, secretion, and sensation most commonly affected. Nonetheless, symptoms in the older adult population should not be routinely attributed to these changes—geriatric patients with GI symptoms should undergo careful evaluation to rule out pathological conditions. Older adult patients scan often presents with atypical symptoms and more severe forms of common GI disorders. In addition, accruing medical problems and medications can affect the GI tract, thereby causing or exacerbating GI diseases. Three common disorders seen in the geriatric population are dysphagia, gastroesophageal reflux, and peptic ulcer disease. Dysphagia may be caused by systemic disorders, primary GI inflammatory and motility disorders or may be caused by medication side effects. Gastroesophageal reflux disease (GERD) is amongst the most common GI diseases in this population and can presents with a markedly varied and atypical symptoms and can be difficult to differentiate from cardiopulmonary disorders. Care should be taken to rule out heart and lung disease and early evaluation of reflux should be completed because GERD is the primary risk factor for esophageal cancer. Peptic ulcer disease is commonly seen as a result of chronic nonsteroidal antiinflammatory drug use in the older adult population, although globally Helicobacter pylori infection is the most common cause and should be ruled out in all patients. Bleeding is the most common worrisome complication and thus early diagnosis and treatment is critical. In all GI diseases, imaging and endoscopic evaluation are typically warranted, and concurrent empiric medical treatment may be reasonable.